Monthly Archives: May 2015

People with H.I.V. should be put on antiretroviral drugs as soon as they learn they are infected, federal health officials said Wednesday as they announced that they were halting the largest ever clinical trial of early treatment because its benefits were already so clear.

The study was stopped more than a year early because preliminary data already showed that those who got treatment immediately were 53 percent less likely to die during the trial or develop AIDS or a serious illness than those who waited.

The study is strong evidence that early treatment saves more lives, the officials said. Fewer than 14 million of the estimated 35 million people infected with H.I.V. around the world are on treatment now, according to U.N.AIDS, the United Nations AIDS-fighting agency. In the United States, only about 450,000 of the estimated 1.2 million with H.I.V. are on treatment, according to the Centers for Disease Control and Prevention.

“This is another incentive to seek out testing and start therapy early, because you will benefit,” said Dr. Anthony S. Fauci, director of the National Institute for Allergy and Infectious Disease, which sponsored the trial. “The sooner, the better.”

Get to know the HIV doctors behind #AskTheHIVDoc – Dr. Demetre Daskalakis and Dr. David Malebranche. In a frank, no-nonsense style, they answer common questions from gay men about HIV and sexual health. For more info, visit: http://greaterthan.org/speakout.

The U.S. Centers for Disease Control (CDC) recently announced $185 million in funding for three new programs to prevent HIV infection among transgender people and gay, bisexual, and other men who have sex with men (MSM), with a particular focus on MSM of color.

The programs are part of a multi-pronged strategy to address the disproportionally heavy burden of HIV infection on MSM and transgender men and women. These programs will help health departments and local HIV prevention partners deliver and apply the most effective HIV prevention tools.

In particular, CDC plans to award up to $125 million over a three-year period to state and local health departments to expand the use of: 1) pre-exposure prophylaxis (PrEP) for uninfected MSM and transgender people who are considered at substantial risk for HIV infection; and 2) ongoing medical care and antiretroviral treatment for people already living with HIV. Health departments will be funded to provide PrEP information and referrals and to conduct outreach and training to increase the number of healthcare providers who are knowledgeable about PrEP and offer it to their patients.

The New York City Department of Health and Mental Hygiene’s recent fear-based HIV prevention campaign may have led to unintended consequences by stigmatizing young black and Latino men who have sex with men (MSM). Publishing their findings in Health Affairs, researchers analyzed the 2010 “It’s Never Just HIV” campaign, which used fearful, horror-movie-like imagery and messaging to highlight health problems tied to HIV or its treatment, such as osteoporosis, dementia and anal cancer.

“Relying on fear is risky business,” the authors write in the paper. The health department came to appreciate that its analysis of the campaign’s success could not be governed simply by HIV rates among the target population. Rather, the department needed to consider the campaign’s social and political impact. Not only was there a huge amount of controversy among people in the HIV community, but according to certain criticisms, people at risk of HIV and those living with the virus may have suffered stigma as a result of the campaign.

New York City has since moved away from fear-based HIV prevention campaigns. For example, “Be HIV Sure,” which launched on World AIDS Day 2014, encourages HIV testing as part of sexual intimacy.

[D]oes non-disclosure matter? Is it associated with poorer health outcomes? While a quantitative survey, completed on a single occasion by respondents, has some limitations in terms of the insight it can give into the quality of people’s lives and relationships, these data are reassuring.

Mental health difficulties and adherence problems were quite common among survey respondents. But they weren’t more frequently reported by people who hadn’t disclosed to anyone. After statistical adjustment for other factors that could skew the results, rates of the following were very similar in people who disclosed and people who did not:

Low social support.

Symptoms of depression.

Symptoms of anxiety.

Problems with adherence to HIV treatment.

A detectable viral load.

In fact, some of the data suggested that having disclosed to most or all friends and family was actually associated with poorer outcomes in gay men. A more selective disclosure strategy was associated with better outcomes.